What's the Difference Between Caregiving and Caretaking?

Caring for Ourselves as We Care for Others

It's like if you were walking outside in a thunderstorm, umbrella-less, and you walked into a café filled with plush armchairs, wicker baskets full of flowers, and needlepoints on the walls that say things like "Be kind to yourself" and "You are enough." It's jarring, the change in scenery, but nice. It also makes you realize that you're soaked—you'd almost gotten used to it, out in the storm.
—Julie Beck

The paradox of choosing to practice what I described as "empathetic compassion" is that such an act has the potential to fill you up both emotionally and physically or suck you dry. I know that if I'm doing my caregiver best—respecting both my own and another's boundaries, acting with intention and self- awareness, recognizing my own limits, and trying to maintain a healthy balance—I generally emerge from a caring experience energized and satisfied. I feel good about the interaction and usually feel closer to the person I'm helping.

However, if I slip into my all-too-familiar caretaker ways, acting or committing to help someone without thinking it through—for example, saying yes when I already had too much on my plate or my motives were debatable—I often emerge feeling somewhat anxious often regretting that I had not made better choices. In those instances, I also find it's easy to let some resentment creep in.

Sometimes, doing favors can hold a mixture of frustration and satisfaction all at the same time.

Most humans have the capacity and instinct for empathy and compassion. However, that doesn't mean we all choose to act on those instincts. Let's face it: Putting ourselves out there can be risky business. Sometimes agreeing to do a favor can feel like an imposition. It takes time, energy, and a good dose of self-confidence to care for others, so why do it?

I hope to answer that question by taking an honest look at the benefits and challenges of caregiving. It will also discuss how practicing good self-care can help prepare us for many of the caregiving challenges that may come our way so we can get more joy and fulfillment out of a caregiving experience. As has been the case so far, this discussion pertains to all kinds of caregiving situations. In my book, Take Good Care, I take a deeper look at the unique aspects of caring for a loved one with a serious injury, illness, or condition in upcoming pages.

Why Should We Care?

It's true that without safeguards or appropriate assistance in place, caring for others can take a serious toll. Yet recent studies show that—generally speaking—helping others has numerous benefits. For instance, the 2013 study I mentioned in the introduction that Michael Poulin and other researchers conducted over a five-year period showed that helping others can protect our health by lessening the negative effects of stress and lengthening our lives.

But the positives don't stop there. The 2007 U.S. Government report produced by the Corporation for National and Community Service reviewed decades of research that illustrated the health, social, and political benefits of volunteerism. As was the case with the Poulin study, the government report underscored that—even when controlling for factors such as age, health, and gender, individuals tend to live longer when they help others. Longevity isn't the only benefit that comes from helping others. The report concludes by stating:

While these studies may differ in terms of their specific findings, they consistently demonstrate that there is a significant relationship between volunteering and good health; when individuals volunteer, they not only help their community but also experience better health in later years, whether in terms of greater longevity, higher functional ability, or lower rates of depression. In addition, we present first-time evidence that when a state has high volunteer rates, they are more likely to have greater longevity and less incidence of heart disease.

In other words, when you help, helping helps you and makes for a healthier community. The studies show there is less depression, more sense of purpose, greater life satisfaction and happiness, higher self- esteem, and better physical health among those who offer service to others. These positive effects are also prevalent among those with chronic or serious illnesses.

For instance, studies found that persons suffering from chronic pain experienced less pain intensity and decreased levels of disability and depression when they began to serve as peer volunteers for others who also suffered from chronic pain. And individuals who volunteered after recovering from a heart attack reported a reduction in despair and depression and a greater sense of purpose in their lives.

Interestingly—while volunteers in general reported positive mental and physical benefits from helping others—older volunteers were found to experience a greater sense of life satisfaction and greater positive changes in their perceived health than younger volunteers. Researchers speculate that this may be because younger people who help out might feel some sense of obligation that is linked to their other responsibilities, like parenting, whereas older helpers have more discretion in how and whom they choose to help. In Rose's family, volunteering crosses generational lines.

Rose's StoryI guess you'd call us a Boy Scout family. My husband, Dave, achieved the highest rank—Eagle Scout—when he was in his teens, so he was thrilled when all three of our sons showed an interest in scouting. Dave was a troop leader, and I helped out too. Dave and I had full- time jobs, and it wasn't always easy balancing work with all the kids' activities—camping trips, meetings, service projects and the like—and, quite honestly, sometimes it felt more "have to" than "want to." But it was such a great way to be involved in their lives and to get to know their friends and caring for their friends' parents. Now our kids are grown up and have their own kids, so we have another generation of scouts—both boys and girls. Dave and I often get recruited to help, and we love having this thread of connection with our kids and grandkids. We go to cookouts, carol with them at nursing homes, serve meals at homeless shelters; even help sew badges on uniforms. I think organizations like this are a good vehicle for teaching kids the importance of service to others. It's great to see them so involved in the community.

Although an increasing body of research gives us evidence of the positive, mental, psychological, and social benefits that caring for others can provide, I don't think we need studies to convince us how good we can feel when we help another person. And as Rose points out, sometimes the benefits trickle down, solidifying family connections as we connect with others in our community. Before I began writing this book, I brainstormed my own list of benefits that caregiving can offer. Here, in no particular order, is my off-the-top-of-my-head list.

To me, caregiving:

is an opportunity to practice empathy and compassion

is a chance to redefine, improve, and evolve relationships, making them more honest, open, and deeper

is an opportunity to exercise and rediscover the better parts of ourselves

is an opportunity to practice life skills like living sanely and serenely

is an opportunity to give back

is a chance to practice and appreciate the present moment

is a way to get us "out of our own heads"—lessening worry and depression

if we're in a Twelve Step program, is a chance to practice the Twelfth Step— the "service Step" (more about this later)

is a chance to develop new and more intimate connections

is a reason to get out and get moving

provides a chance to improve communication skills

offers the opportunity to expand or discover community (e.g., mutual caregivers, others in the same situation, the community surrounding the person for whom we are helping)

is a chance to practice reaching out, asking for, and accepting help

is a possible time of rediscovery/recovery/reconnection

is an opportunity to practice "delegation" skills

is an opportunity to use teachable moments with kids (more about this later)

can help us learn or hone different practical skills (e.g., cooking, home repair, navigating a computer or smartphone)

is a way to put our values into action

is a way to expand our own caring circle for times when we might need help

is an opportunity to connect with and learn from individuals of different ages, ethnicities, cultures, beliefs, and experiences

Take a minute to review my list. What benefits would you add? Individuals like Linda who have been helped in hard times and others who survived trauma and serious illness have also told me how being of service is a way to express gratitude.

Linda's StoryYears ago, when I was a single mom, I got laid off from work and had to get help from community social service programs. I can still remember how embarrassed I was the first time I had to use food stamps and how hard it was to accept help from friends or shop at used clothes stores for clothes for my kids. But I was so grateful to have that help.

I try never to forget what those years were like, and now I volunteer twice a month at a local community service organization that provides food, clothing, school supplies, transportation, and other assistance to residents in need. I love interacting with the folks who come in for help, and I try my best to put them at ease when I sense that same sense of embarrassment I felt so deeply when I was in their shoes. My favorite thing is helping families choose toys for their children at the holidays. The place is decorated so beautifully, and it's so gratifying to watch a mother's or father's delight when they find exactly what they had in mind for their kids.

As these stories and the above list show, when we have opportunities to practice healthy and balanced caregiving, the rewards we gain can be plentiful. However, when our caring lives get out of balance and we find ourselves— sometimes out of habit, sometimes out of necessity— being more caretaker than caregiver, many of the above positives can disappear.

When Caring Consumes Us

The Signs and Symptoms of Stress
Left untended, long-term stress can lead to serious health problems, like ongoing high blood pressure, a suppressed immune system, an increased risk of heart attack and stroke, severe headaches, or sleep problems. It can also lead to eating disorders, depression, or addiction problems.

Caregivers who experience a number of the following signs and symptoms risk stress overload:

Cognitive Symptoms

Memory problems

Inability to concentrate

Poor judgment

Seeing only the negative

Anxious or racing thoughts

Constant worrying

Physical Symptoms

Aches and pains

Diarrhea or constipation

Nausea, dizziness

Chest pain, rapid heartbeat

Frequent colds

Emotional Symptoms

Moodiness

Irritability or short temper

Agitation, inability to relax

Feeling overwhelmed

Sense of loneliness or isolation

General unhappiness

Behavioral Symptoms

Eating too much or too little

Sleeping too much or too little

Isolating yourself from others

Using alcohol, cigarettes, or drugs to relax

Nervous habits like nail biting

Take a moment to review these symptoms of stress. Have you or someone you know experienced any of these when caring for others? How many are you or they experiencing now?

Stress is like the tension on a guitar string. If the string is turned too tightly, it snaps; if it is strung too loosely, it is limp and sounds dull. Again it comes down to balance. A little stress can keep us at the ready. When stress throws our lives out of balance, however, our "inner strings" can stretch to the breaking point or go limp, leaving us feeling depleted or even depressed.

The longer we ignore stress symptoms, the more serious they can become. If you are consistently experiencing a number of the above symptoms, it might be a good idea to consult a qualified medical professional, as Nancy did. As we'll see, asking for and accepting help is an important element of self- care.

Summing It Up

One Wednesday, a friend emailed a meme that said, "This is your midweek reminder. Relax! You have enough. You do enough. You are enough." Perhaps we should all reproduce these words on an 8½ by 11- inch piece of paper and hang it next to our bathroom mirrors as a reminder each day to slow down and take care.

As we've discussed, self- care is not just a gift we give ourselves. When we maintain healthy boundaries, practice self-compassion, educate ourselves about the warning signs of stress, and practice the other elements of self-care covered in this chapter, we have a better chance of giving compassionate care to others without risking our own health and well-being. Self-care is a prevention tool that helps us more effectively meet caregiving opportunities and challenges with self-awareness and intention. Julie Beck, the writer quoted at the beginning of this chapter who compared the lack of self- care to being in a thunderstorm without an umbrella, closed the article from which her words were taken by saying, "The chaos swirls out there, and you eventually have to wade back into it. But if you stop by the self-care café, on your way out, you can grab an umbrella to take with you into the storm."

Self-care is shelter from the storms of life that may come our way or strike our loved ones. Practicing good self-care all the time better prepares us for the particularly difficult caregiving situations that will be discussed in the next chapter. We'll also talk more about the extreme importance of caring for ourselves in these circumstances and explore ways to expand our own circle of support.

Orange co-facilitates a group for caregivers of a variety of ages and circumstances that was founded in 2010. She has written extensively about caregiving and post-traumatic stress disorder, and she and her husband, Michael, a Vietnam combat veteran, often speak to audiences about the effects of trauma and war in their continuing involvement with veterans and veterans' issues.

When we're more caretaker than caregiver, many of the above positives can disappear.

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